Health Expense Sharing Organizations

A question I am getting more and more is, "Should I look into a Health Sharing Organization for my Health Insurance needs?"

It is a great question and the answer is always, maybe!

I know most people dont like  that answer for anything, but it is the truth.  Here are some of the pros and cons of these types of organizations and you need to consider what is the best option for you and your family.

Ill start with the positive things about these ministries

1. You dont have to pay the fine if you join one of these.  For younger people with good incomes, it is cheaper for them to join one of these organizations as opposed to paying the fine.
2. Premiums are low.  Many times the premium is less than half of what we are seeing today in the Johnson City, Kingsport, and Bristol area of Tennessee.
3. They dont allow coverage for morally objectionable behavior.  Your payments dont support things like sex change operations that are now covered due to the Affordable Care Act.
4. From what I am hearing, most people have their claims paid without any problems.

Now for the negatives that you need to consider

1. This is not insurance so there is no guarantee that your will be reimbursed for your expenses.
2. Almost all of these are reimbursement plans so you will have to pay money out and wait to be reimbursed in some situations especially if the provider requires you to pay before the procedure.  I know that when we have had surgery at Mountain Empire Surgery Center, we had to pay everything up front before they would start the procedure.
3. These organizations are not very large so there might be a problem should a large event happen.  Most have less than 200,000 members around the whole United States.  Compare that to just Blue Cross of Tennessee with 3,400,000 members.  Christian Care Medi-Share says that they have shared in over $1,200,000,000 in medical bills of its members.  Conversely, Blue Cross has lost almost 1/2 of that since 2014, closing in on $500,000 as we end the year.  Think about that, in 3 years, Blue Cross has lost half of what the sharing ministry has shared in 23 years.... and Blue Cross is still a financially strong company.
4. As I mentioned in number 3 above, they are going to exclude things that are morally objectionable so you may not be able to get coverage.  If you drink alcohol, use tobacco products, or do things that are dangerous, you may not be able to get coverage.  In addition, if you or one of your dependents does something and has a wreck with alcohol around, you wont have any coverage nor would you have coverage if someone were to get pregnant out of wedlock.
5. Most have exclusions or at the very least, limitations for pre-existing conditions.

So we have the good and the bad but now we have some solutions to the bad problems.  Since there are no more pre-existing conditions, if you do get something really bad and need a lot of care, you can always move from one of these plans to an ACA qualifying plan the next January 1 (or if you need it sooner, just move to a different service area and you will get an open enrollment opportunity) and you will have everything covered going forward.  If you get pregnant, just get married and you will have a an opportunity to enroll.

So there you have it in a nut shell,  If you have questions, please call us, we do have friends who can sell these plans if you would like and can give you their information.  As always, we would be honored to help with any of your insurance needs- Home - Life - Work Comp- Auto- Business- Medicare Supplements- Employee Benefits- and anything else that ends in INSURANCE.